Prognosis: Disastrous

Doctors speak out about their struggles

with a "broken" medical system

EDITOR'S INTRO

Are hospital bottom lines

compromising patient care?

Sedona, Ariz., is a center for alternative medical care, with many practitioners offering a multitude of healing modalities. However, city residents and those in surrounding Verde Valley communities rely on one solitary hospital provider for all their inpatient and outpatient surgical and emergency needs - ones that many local medical professionals claim are not being properly met.

Inquiring minds want to know.

As an award-winning professional journalist with a column focusing on socioeconomic issues in the Verde Valley for the past several years, I began to focus more on health care in 2004.  Residents were contacting me to complain about obscene hospital bills ("$50 for an aspirin" and "nearly $800 to step foot in the emergency room"), as well as subsequent "harassment and bullying" from the billing department despite their best efforts to make payments in good faith.

Health care in America, right? Maybe not. Was there a deeper problem in northern Arizona?

Sure enough, I began receiving more e-mails than ever from nurses stating that profit-motivated hospital policies were negatively impacting their ability to administer proper patient care. As a result, medications were "mixed up" and some patients "never saw a nurse during their stay," or "were booted out prematurely for lack of money."

Several reports also began surfacing from regional medical professionals with serious allegations about the same regional medical provider the patients and nurses were incensed about. After 30 years of daily news experience, my reporter's instincts knew a vital story waited to be told - one that might possibly save lives.

I didn't want to create sensational headlines that would sell papers for my publishers; I had long ago left the body-bag journalism of the major urban dailies to dedicate my work to community journalism. I just wanted to get to the bottom of these disturbing claims.

What if they were true? And, if they weren't, why would so many medical professionals bother to submit such reports to the press?

Despite my attempts in 2005 to document them in an article called "Prescription for Profit?," I encountered a stonewalled press more interested in the provider's advertising dollars than its alleged unethical practices. Since local publishers remained unwilling to pursue a proper journalistic examination of the claims pouring in from local and regional medical professionals, I realized I would have to do it myself.

The silence had to be broken. Thus The Sedona Observer was born in 2007 as an online nonprofit newspaper dedicated to positive social change by shunning advertising to uphold freedom of the press and to preserve its editorial integrity.

As a 501c3 free press, The Sedona Observer focuses on reporting the truth about health care in the Verde Valley and northern Arizona, as well as across the nation. We believe it represents the single issue that unites us all as Americans - as a matter of life and death.

Rich or poor, young or old, liberal or conservative, citizen or immigrant, Democrat or Republican, insured or uninsured - today's broken health industry leaves no one unscathed. Just turn to our ongoing "SiCKO in Sedona" page for examples.

The stories in the first issue, such as "From Hippocrates to Hypocrisy" and "The Economics of Breast Cancer" highlighted the problems plaguing American's medical industry while also posing some possible solutions and alternatives.

Read the articles by clicking on the picture below.

The inaugural edition also featured testimonials from nurses and doctors in "Condition: Critical." As a result, the paper continues to receive  a steady flow of statements from doctors and nurses citing their concerns about patient neglect, price gouging, workplace abuse and administrative problems in the regional hospital system.

The public response has been incredible, and the letters keep clamoring for more. The people have the right to know what's happening - to doctors, nurses and their neighbors - so we can determine what needs to be addressed and if the situation represents a public safety issue.

The following testimonials were submitted to The Sedona Observer by physicians expressing their frustration with the current medical system and the operating practices of the regional hospital administration. Most requested to remain anonymous for fear of retribution from some of their peers, as well as from the facility itself.

It's a sad day in America when our healers have to cower in such fear, as understandable as it may be. Still, we commend them for their courage to speak out and uphold their medical ethics.

The Sedona Observer presents these statements as allegations and not as fact or the editorial opinion of this newspaper. Therefore, we have also eliminated the names of any individuals, organizations or institutions from the testimonials because they represent unproven reports. The letters also remain unedited except for style, grammar, case and punctuation.

We are publishing them to give doctors a voice about the everyday challenges they face in today's medical system and, as they put it, "in order to save people's lives and wallets from ruin."

While it is not our policy as journalists to use anonymous sources, at the same time, we believe that it must suffice as a matter of public safety until people start going on the record. Without anonymous sources, Watergate would have been forever silenced and buried, representing a huge loss to America.

Meanwhile, our investigation continues - one that will require patience, diligence and a significant amount of time. We welcome any opposing views so we can highlight all sides of the issue for the general public. So far, our requests for statements have been met with silence.

For now, the jury remains out as we pursue our investigation in accordance with journalism ethics - with accuracy, dignity and integrity.

Here now are the doctors' reports in their own frightening words.

"I am horrified by the treatment

of unsuspecting patients"

"My observations suggest that the organization’s 

money-making formula has resulted in avoidable harm

to patients as collateral damage." 

To The Sedona Observer:

"As a practicing physician, I have firsthand and insider knowledge of what is going on at the regional hospital network.  I am horrified by the treatment that some unsuspecting patients have received within that system.  The system, ostensibly a nonprofit organization, does not always put patients' welfare and safety first, but is designed to maximize profits, with sometimes disastrous consequences.

My most pressing concerns relate to harm to patients that occurs within this system.  My observations suggest that the organization’s money-making formula has resulted in avoidable harm to patients as collateral damage. Working within this hospital system, and right outside in the area, I have witnessed:

1. Avoidable injuries and complications, including death, due to the network’s failure to pay for and implement basic, commonplace patient safety measures for procedures;
2. Unnecessary patient measures done to maximize profits, without regard to the medical situation of the patient;
3. Performance of elective high-risk procedures within the system, even though the administration knows full well that patients would receive much safer and better quality care at specialty facilities in Phoenix;
4. False and deceptive advertising, misleading the public as to what can and what cannot be done safely within the hospital system, in an attempt to lure paying patients into receiving risky (for the patient) and lucrative (for the hospital) procedures at an institution that cannot perform these procedures as safely as they can be performed elsewhere.

A second concern relates to the harm the organization has done to the medical community.  It rules the nurses and doctors that work within the hospital network with an iron fist, literally terrorizing those who dare to speak up against the system. 

Again, working both within this system, and right outside in the area, I have witnessed:

As a patient advocate, I am observing this organization’s practices with the utmost concern on behalf of public health and safety."

Sincerely,

R.W., MD

Flagstaff, Ariz.

"Patients pay the outrageous price for unnecessary helicopter rides"

"The hospital makes more money in not treating patients because it has developed a lucrative scam

of airlifting them across Arizona." 

"There is a very serious situation in the northern Arizona hospital system that patients need to be aware of so they can protect themselves from financial shock and disaster.

The hospital system has implemented “Key Services” that are most profitable. These services include Cardiology, Orthopedic, Neonatology and Radiology services. All other medical conditions have been give low or no priority. These local hospitals do not provide “general” medical services but put all their efforts and resources in profitable treatments only.

So, if a patient has a neurological problem in Cottonwood, these patients are “flown” to a center that provides neurology services. The hospital has done nothing to maintain or expand this neurological care. The only two neurologists in Verde Valley have closed their practice and moved elsewhere because of lack of support from the hospital.

Therefore, the hospital makes more money in not treating patients because it has  developed a lucrative scam of airlifting them across Arizona.

Instead of developing local health programs and retaining doctors, the medical center would rather get rid of doctors and “fly” patients! The company that manages the hospitals has one of the biggest “Air Ambulance” plane and helicopter fleets in the country.

It costs about $10,000 for a patient to take a ride in this air ambulance – each way. 

In a true emergency everyone would welcome this lifesaving modality, if needed. However, with regards to the hospital, there is a twist.

They use their own hospital helicopters to airlift patients to Flagstaff or Phoenix, for which they get the $10,000 fee. They claim it is for more advanced treatment not available locally.

The hospital administration is also very aggressive in getting market control for “lucrative” medical care (cardiovascular and orthopedic) in which they have put their full focus.  

The hospital advertises 24/7 coverage for its cardiovascular services. However, this is not true. There are many days that these services are “blacked out” because there is no cardiologist or cardiothoracic surgeon coverage available.

They would certify a hospital as being fully occupied because they have no beds available – so patients need to be transferred. Most of the time it is not that all hospital beds are occupied but, rather, because the hospital has failed to hire more nurses to cover all the beds available in the hospital.

This would mean, in an emergency, you will be airlifted to a sister hospital at a very hefty profit to the hospital.

For example, if a patient comes to a hospital up there with chest pain – and it is a “blackout” day there – the patient is airlifted to an affiliate hospital. An angiogram is done, and the patient needs bypass surgery. The patient is then airlifted back again at a cost of $20,000 payable to the hospital’s air evacuation operation.

The patient ends up paying the $20,000 air ticket because usually this modality is not covered by insurance. Or, if the patient is covered, the insurance contractors have to pay because they have no choice.

Is this in the best interests of patients? You judge for yourself."

J.S., MD

Phoenix

"The fatal cost of

profitable treatments "

"Patients have the right to know about procedures that can pose risks to their physical and financial well-being - esp. when safer, more affordable alternatives exist."

"As a physician it is very hard for me to have to write this, but I strongly believe that patients have the right to know about procedures that pose risks to their physical and financial well-being - especially when safer, more affordable alternatives already exist.

When you look at  the regional hospital system’s sleek advertisements and public relations talks, you may be impressed at first glance. However, there is a very sinister side to this organization.

It is in cahoots with its lackey doctors, having connived to offer the treatments and procedures that bring in the most money, or because this is the only competency level of the physicians. I know because I once worked there.

Here is one blatant example of how NOT to offer alternative, less invasive and safer treatments. 

The hospital has recently started to advertise the “new” and “innovative” treatment for atrial fibrillation (a condition in which the heart becomes irregular and may lead to a stroke)  by a surgical method called Atrial Fibrillation (MAZE) procedure. They tout this is a “new surgical option” that “only requires four small incisions.”

This treatment was developed over 20 years ago and is now rarely used for treatment of this condition as a first option. Advances in minimally invasive and sometimes outpatient procedures have superseded this archaic modality.

There are procedures called electrophysiological ablation, Watchman occlusive devices for stroke prevention, etc., that require overnight stays in the hospital after treatments. Well what do you know! These modern procedures are NOT offered by this hospital system.

Their advertisements they make no mention of these new, innovative and safer modalities. We expect our local hospitals to be an advocate of the people they serve. But they are  a big advocate of their profits! Do not be fooled.

Today your care is driven by money rather than what is in your best interest. When you purchase medical services with your health dollar, BUYERS BEWARE! Do your own due diligence and trust only yourself. Educate yourself on alternative treatment available, not what your local hospitals and their affiliated doctors (who milk the hospital cash cow as well) offer."

A.K., MD

Scottsdale

READ ANOTHER DOCTOR'S TESTIMONIAL

ON PAGE 2 OF

THE LESLYE KINCADE STORY

Cutting Medical Costs

Hospital Prices Revealed

According to HospitalVictims.org, many hospitals earn obscene profits by charging patients three of four times the actual cost of the provided medical services.

Designed for those faced with “financially impossible” hospital charges, the site helps people defend themselves from being overcharged by offering tools to determine the discount hospitals normally give to big insurance plans.

By knowing the average price structure charged to Medicare and private insurance providers, patients can fight back and protect themselves from financial disaster.

Visit http://www.HospitalVictims.org.

 COMING IN OUR NEXT ISSUE

"DON'T BLAME THE DOCTOR"

 It's not the physicians; it's the system

Designed to educate members of the public, this article will help people realize that doctors have become victims of a merciless system that dictates their practices and how they are they are able - or unable - to provide for their patients.

Highlighting how neither doctors nor patients have much say in the transformation of today's health care system, the article explains how insurance carriers hamper many physicians and, in some cases, force them to shut down their practices due to impossible rules and regulations.

This riveting report reveals what both doctors and patients need to know to protect themselves.

SPREAD THE WORD AND HELP SAVE LIVES!

FORWARD THIS INFORMATION TO DOCTORS, MEDICAL ASSOCIATES AND PATIENTS

SUBMIT YOUR PHYSICIAN TESTIMONIAL HERE

or e-mail editor@SedonaObserver.com

CLICK HERE FOR YOUR FREE SUBSCRIPTION

MAKE A DONATION TO SUPPORT A FREE PRESS

CHECK OUT NURSES' STORIES IN

THE ALARMING REPORT:

CONDITION: CRITICAL

READ THE LAST ISSUE'S RIVETING STORY:

"From Hippocrates to Hypocrisy"

Any claims or allegations implied by the public or contributors do not reflect or represent the editorial opinion of this newspaper.

The Sedona Observer will continue to investigate any reports made by patients against health care institutions as part of our journalistic responsibility to expose abuse and social injustice against humanity with dignity, accuracy and integrity.

We abide by media law and uphold the time-honored policies of the Journalism Code of Ethics.

The Sedona Observer publishes all opinions under the First Amendment and welcomes those with any opposing views to submit letters and testimonials.  

Troubled Waters

at VVMC ?

Questions linger in the wake of its president's sudden departure

By Mike Cosentino

The hasty and hushed departure of VVMC President Jim Sinek sent shockwaves across the Verde Valley last month, raising many business and medical eyebrows over the grounds for his official resignation.

Sinek was placed on administrative leave Thursday, January 17, when speculation regarding his tenure at the hospital began.

The hospital board called an emergency meeting Tuesday, January 22, at 3:30 p.m., voting to terminate Sinek's contract. It then issued an official statement “accepting his resignation,” with a sheet of quotes about his service and announcing his replacement.

Sinek had presided over the hospital since 2003.

On January 23 the VVMC Board of Directors and Northern Arizona Healthcare officially named Jack Dempsey, NAH executive vice president, as interim administrator to oversee hospital operations while they conduct a national search to replace Sinek.

VVMC Board Chairman Alan Everett said, "The hospital remains progressive and focused on delivering the highest quality health care."

Dempsey, an attorney, is a resident of Cornville and has served on the Flagstaff Chamber of Commerce, Greater Flagstaff Economic Council, State Bar of Arizona Real Estate Council, Flagstaff Town Hall, Native Americans for Community Action, and the Flagstaff Water Commission.

The timing and speed of the VVMC governing board in deciding to terminate Sinek’s contract and announce Dempsey’s interim appointment raises some questions.

According to some local sources, Sinek isn't the only staff member exiting the hospital. They claim that many doctors have already abandoned ship.

"A steady parade of medical staff has left the Verde Valley and terminated or changed their status with the Verde Valley Medical Center over the last few years," said Alex Horchak, a local urologist who is certified at VVMC.

"A lot of doctors have left,” he added. “We had four surgeons, and we were down to two for a while. That must say something."

Horchak also said that he gave notice to Sinek that, as of February 1, 2008, he would be working on a "consultant-basis only" with VVMC – adding fuel to the questions surrounding Sinek's departure from the medical center.

No other urologist is currently listed in the hospital’s directory.

NAH is the parent corporation of VVMC, VVMC-Sedona Campus, Flagstaff Medical Center, Northern Arizona Homecare and Guardian Air and Ground Transport. Winslow Memorial Hospital is under a management contract with NAH.

Mike Cosentino is an investigative reporter who focuses on politics and education, among many other issues.

E-mail mcosentino@SedonaObserver.com.

Editor's Note

What Ails Northern

Arizona Healthcare?

From official reports of labor disputes at Flagstaff Medical Center to departing doctors and evident administratiON woes at VVMC, concern about the well-being of Northern Arizona Healthcare continues to spread in the regional medical community, according to some local doctors.

Labor law violations

The National Labor Relations Board has indicted Flagstaff Medical Center on 53 counts of labor law violations for ongoing illegal activity related to its attempts to “break up employee unionizing efforts” at the hospital.

According to the National Nurses Organizing Committee, the NLRB also found that “the hospital's CEO violated the law when he swept through the hospital threatening nurses they would lose out on future raises if they unionized.”

The NLRB has charged the hospital with illegal action by threatening employees with the loss of pay increases and retirement benefits if they vote to join NNOC. The complaint came as a result of a thorough field investigation last year by labor board agents in Flagstaff, involving examination of hundreds of hospital documents. 

Disgruntled nurses

The NLRB also alleges that FMC has "threatened its employees with loss of wage increases and benefits if they supported the union and with unspecified reprisals because they discussed their appraisals and other terms and conditions of employment with their fellow employees.

It also charged the hospital with “creating an impression among its employees that their concerted activities were under surveillance." Hospital officials continue to deny the allegations, citing the charges as “union tactics.”

A previously scheduled court hearing to review the charges was postponed pending a new date that has yet to be announced.

FMC nurses and other employees filed their complaints in the last issue of the Observer. Read their allegations on the Condition: Critical page and the Labor/Workplace page.

Sudden VIP resignation

Some medical sources say that former VVMC President James Sinek's contract was terminated because he had "initiated takeover talks" with a Cottonwood imaging laboratory before clearing it with Northern Arizona Healthcare's Governing Board and its legal department.

“The takeover would have significantly and adversely posed significant legal challenges for NAH since it is already engaged in an antitrust lawsuit with physicians at that facility,” commented one physician affiliated with the hospital.

The doctor stated that some members of the local medical community believe Sinek was pursuing the takeover bid because it would enable VVMC to maintain “a monopoly presence in local health care services, continuing to charge up to three or more times for local outpatient services rendered when compared to Phoenix facilities.”

Profit-motivated health care

For the past five years, insurance premiums for private insurers in northern Arizona have gone up by more than 600 percent because of sole "nonprofit" hospitals operating in the local communities.

These hospitals were granted "special privileges” years ago when northern Arizona was considered a "rural" community.  Therefore, such "nonprofit" hospitals enjoyed a subsidy from state and federal government in the past because of the "rural" designation, while “charging up to three times more” for some procedures than hospitals in Phoenix for similar services.

Approximately three years ago, Yavapai and Coconino counties were designated "urban" communities by the federal government (meaning the communities were large enough to sustain themselves without state or federal government subsidies).

What does this translate to?  An opportunity for growth, expansion and competitive health care services. This allows local communities to not only empower themselves to create the most cost-effective health care systems, but also allows "for-profit" health care providers to compete with the local "tax-exempt" hospitals.

In other words, such a designation basically opens up avenues for competing local health care services, inviting better-priced patient choices.

“Bilking” patients?

Because of these changing demographics and regulations, most local hospitals in northern Arizona have initiated plans to maintain "Single Provider" status, allowing them to dictate contract terms to private health insurance companies.

That way they remain competitive and profitable because they are “the only game in town,” forcing doctors and patients to comply with their terms.

Most insurance companies have no choice but to make a deal with these local "non-profit" hospitals and, of course, they pass the increased cost that result from the lack of choice to the patients – including working poor and middle-class families already struggling financially under a costly health care system.

“They are bilking the public in their local communities,” declared one Flagstaff physician who also preferred to remain anonymous, like the others, for fear of “retaliation.” He added: “The residents of these communities are blind to the fact that this is going on because NAH conducts a powerful and effective public relations campaign. They need to wake up and realize what’s really going on."

Is NAH the healing haven portrayed in its glowing ads, or is it a troubled ship laden with holes sailing across stormy seas? The charges spur some journalistic questions, especially when so many remain unanswered.

VVMC/NAH board members have not offered any details regarding Sinek's sudden departure and did not respond to the Observer's calls or e-mails regarding the other charges by press time.

We welcome their response to these and other allegations from the medical community, including concerned doctors and nurses and disgruntled employees, in order to create balanced and fair reporting for the common good.

Catherine Rourke

Managing Editor

Penny wise, pound foolish

Studies show that hospital profits warrant the hiring of sufficient nursing staffs to ensure proper patient care

According to Modern Healthcare (November 7, 2005), aggregate hospital profits in 2004 nationally climbed to an all-time record of $26.3 billion, with net profit margins at a six-year high.  

Nurse-to-patient ratios have been demonstrated to produce significant long-term savings for hospitals by reducing patient care costs. By improving staffing conditions, ratios also help hospitals cut RN turnover and reliance on nurse registries. Data also shows that most hospitals can afford to employ sufficient numbers of nurses to provide "safe ratios."

The January/February 2006 issue of Health Affairs states that raising the proportion of nurses by increasing RN staffing to match the top 25 best-staffed hospitals would produce net short-term cost savings of $242 million. It also states that more than 6,700 in-hospital patient deaths and 60,000 adverse outcomes could be avoided.

The Institute of Medicine of the National Academy of Sciences reports that "nurse staffing levels affect patient outcomes and safety.” Insufficient monitoring of patients, caused by poor working conditions and the assignment of too few nurses, increases the likelihood of patient deaths and injuries. The study concludes: “How well we are cared for by nurses affects our health and sometimes can be a matter of life or death.”

According to JCAHO, the Joint Commission on Accreditation of Hospital Organizations, inadequate staffing precipitated one-fourth of all sentinel events — unexpected occurrences that led to patient deaths, injuries, or permanent loss of function, from 1997 to 2002.

The Journal of the American Medical Association reports: “Up to 20,000 patient deaths each year can be linked to preventable patient deaths. For each additional patient assigned to an nurse, the likelihood of death within 30 days increased by seven percent. Four additional patients increased the risk of death by 31 percent.

HB 2041

The Arizona Hospital

Patient Protection Act

In Arizona, a new bill introduced to the legislature is designed to establish safe proper nurse-to-patient staffing ratios.

Introduction of the bill was hailed by nurses across the state who have voiced increasing alarm about the erosion of care conditions in Arizona hospitals that they say put patients at risk and fan the nursing shortage since many nurses will no longer work in unsafe hospitals.

The legislation would make Arizona hospitals safer by guaranteeing safe nurse-to-patient ratios, protecting the right of nurses to act as whistle blowers against unsafe conditions, and offer legal recognition of the professional and moral obligations of nurses to act as patient advocates, solely in the interests of their patients.  

Click here for the full details of

HB 2041.

Catherine Rourke

Got a medical testimonial,

editorial commentary

or counter-opinion?

E-mail editor@SedonaObserver.com.